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y3 summary > haem > Flashcards

haem Flashcards

1
Q

reed-sternberg

A

hodgkins lymphoma

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2
Q

enlarged non painful lymph nodes (cervical rubbery)
painful with alcohol
fever night sweats wt loss itch fatigue

A

hodgkins / NHL (both present with B symptoms and similar lymph nodes)

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3
Q

hodgkins blood results with poor prognosis

A

raised ESR

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4
Q

key diagnostic test for lymphoma

A

excisional lymph node biopsy

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5
Q

how is CLL confirmed

A

immunophenotyping

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6
Q

what is an indication to start treatment in CLL

A

B symptoms
rapidly progressing lymphadenopathy/hepatosplenomegaly

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7
Q

how do you confirm lymphoma

A

immunohistochemisty

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8
Q

smudge cells

A

CLL

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9
Q

once bloods returns to normal after anti-leukaemia treatment how do you proceed?

A

one more round of chemo

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10
Q

confirm AML

A

immunophenotyping

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11
Q

neuropenic sepsis Tx

A

tazocin (piperacillin / tazobactam)

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12
Q

hodgkins Tx

A

multi agent chemo (ABVD: adriamycin, bleomycin, vinblastine, dacarbazine) +/- radio

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13
Q

NHL Tx

A

multiagent chemo (R-CHOP: rituximab,cyclophosphamide,hydroxydaunorubicin, vincristine andprednisolone)

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14
Q

common childhood cancer assoc with downs syndrome

A

ALL

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15
Q

what cancer can occur in lymph and blood

A

CLL or myeloma

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16
Q

acute leukaemia affect what kind of cell

A

primitive progenitors

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17
Q

chronic leukaemias affect what type of cell

A

mature

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18
Q

what leukaemia affect bone marrow and blood

A

Chronic myeloid leukaemia/ chronic myeloproliferative disorders
Acute myeloid leukaemia
Acute lymphoblastic leukaemia

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19
Q

what leukaemia is common in elderly

A

AML

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20
Q

auer rod

A

AML

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21
Q

prevent tumour lysis syndrome in ALL

A

allopurinol

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22
Q

characteristics of blast cells

A

high nuclear:cytoplasmic ratio

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23
Q

philadelphia chromosome translocation t(9:22) resulting in new gene BCR-ABL1 and how do u find this cytogenic abnormality

A

CML

FISH

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24
Q

in what condition do you get renal impairment, bone pain and hypercalcaemia

A

multiple myeloma

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25
Q

what condition do u get gout

A

CML

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26
Q

Tx CML

A

tyrosine kinase inhibitor - imatinib
and stem cell/bone marrow transplant

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27
Q

cancer of plasma cells

A

myeloma

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28
Q

bence jone protein

A

myeloma

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29
Q

what immunoglobulin is abundant in myeloma and how do you investigate this

A

IgG - serum protein electrophoresis

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30
Q

Tx myeloma

A

chemo (thalidomide) + alkylating agent (melphalan) + steroid (dexamethasone)

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31
Q

what leukaemia can polycythaemia vera transform to

A

AML

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32
Q

JAK2 mutation

A

polycythaemia vera

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33
Q

aquagenic puritis

A

polycythaemia vera

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34
Q

bloods: very high Hb and erythropoietin levels

A

PCV

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35
Q

Tx PCV

A

venesect to haematocrit <0.45
aspirin
cytotoxic oral chemo eg hydroxycarbamide

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36
Q

dry aspirate
fibrosis of trrephine biopsy

A

myelofibrosis

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37
Q

tear drop RBC (poikilocytes)

A

myelofibrosis

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38
Q

Tx myelofibrosis

A

JAK2 inhibitor - ruxolitinib

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39
Q

iron chelating agents

A

desferrioxamine, deferiprone etc

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40
Q

arterial thrombosis Tx

A

antiplatelets aspirin

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41
Q

venous thrombosis Tx

A

anticoagulants
DOAC - apixaban 1st line
massive PE - thrombolysis

secondary prevention - LMWH (pregnancy) or warfarin (first line in antiphospholipid syndrome)

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42
Q

hereditary thrombophilias

A

factor V leiden
prothombin20210 mutation
antithrombin def
protein C and S def

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43
Q

where does extravascular haemolysis occur

A

majority in spleen

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44
Q

name some types of extravascular haemolysis

A

sickle, thalassaemia, here sphero, haem disease of new born, WARM AIHA

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45
Q

name some intravascular haemolysis

A

mismatch, G6PD, cold AIHA

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46
Q

what drug inhibits prolactin

A

cabergoline (dopamine agonist)

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47
Q

what leads to burkitts lyphoma and what is it caused by

A

NHL, EBV virus

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48
Q

smudge cells

A

CLL

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49
Q

where is EPO produced from

A

kidneys

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49
Q

where is EPO produced from

A

kidneys

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50
Q

foetal Hb contents

A

2 alpha 2 gamma

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51
Q

in what form is iron stored as ferritin/transferrin

A

fe3+

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52
Q

where are clotting factors produced

A

liver

53
Q

what does the common pathway produce

A

thrombin

54
Q

what is the measure of the common pathway

A

thrombin time

55
Q

vitamin K dependent clotting factors

A

II, VII, IX, X

56
Q

embryology sites of haemopoesis: yolk sac

A

week 10

57
Q

embryology sites of haemopoiesis: liver

A

week 6

58
Q

embryology sites of haemopoiesis: bone marrow

A

week 16

59
Q

bone marrow biopsy in child

A

tibia

60
Q

bone marrow biopsy in adult

A

posterior iliac crest

61
Q

cell?

A

normal

62
Q
A

neutrophil

63
Q
A

monocyte

64
Q
A

eosinophil

65
Q
A

basophil

66
Q
A

lymphocyte

67
Q
A

plasma cell

68
Q
A

NK cell

69
Q
A

megakaryocyte

70
Q

cell?

A

megaloblast

71
Q

cell and condition it is seen in

A

target cells
iron deficiency, post-splenectomy, liver disease, thalassaemia

72
Q

cell and condition it is seen in

A

heinz bodies
G6PD, alpha thalassaemia, chronic liver disease

73
Q

cell and condition it is seen in

A

howell-jolly bodies
post splenectomy, sickle, anything with hyposplenism

74
Q

cell and condition it is seen in

A

reticulocytes
haemolytic anaemia
major bleed

75
Q

cell and condition it is seen in

A

schistocytes
HUS, DIC, TTP, heart valves

76
Q

cell and condition it is seen in

A

sideroblasts
myelodysplasia

77
Q

cell and condition it is seen in

A

smudge cells
CLL

78
Q

cell and condition it is seen in

A

spherocytes
AIHA, hereditary spherocytosis

79
Q

cell and condition it is seen in

A

rouleaux
multiple myeloma
Waldenstroms

80
Q

cell and condition it is seen in

A

myeloblast
AML

81
Q

cell and condition it is seen in

A

lymphoblast
ALL

82
Q

cell and condition it is seen in

A

auer rod
AML

83
Q

cell and condition it is seen in

A

tear drop RBC
marrow fibrosis conditions

84
Q

how do you treat shock

A

synthetic colloids ASAP

85
Q

if alloantibody is identified in patient blood what do you need to make sure in the donor blood

A

negative for that antigen

86
Q

indirect coombs test looking for ?

A

alloantibodies

87
Q

what causes megaloblastic anaemia

A

defects in DNA synthesis and nuclear maturation

88
Q

what is B12 rich in

A

meat, eggs etc

89
Q

folate is rich in

A

leafy greens

90
Q

positive blood CANNOT be given to negative patients
T/F

A

T

91
Q

where is b12 absorbed

A

terminal ilium

92
Q

where is folate absorbed

A

duodenum and jejunum

93
Q

why do you not give folate before fixing B12 levels

A

subacute combined degeneration of the cord (affecting dorsal and lateral columns)

94
Q

blood film of B12/folate def

A

hypersegmented nucleus
macrovalocytes

95
Q

blood film of B12/folate def

A

hypersegmented nucleus
macrovalocytes

96
Q

causes of nonmegaloblastic anaemia

A

alcohol
liver
hypothyroidism
marrow failure

97
Q

in blood transfusion what happens if anti-A and group A are put together

A

intravascular haemolysis

98
Q

what can all blood groups recieve

A

donor O group

99
Q

what can recipient group A and AB recieve

A

A

100
Q

what antibodies are present in group A plasma

A

anti-B

101
Q

patient is AB what blood can they recieve

A

all !!!

102
Q

group O what plasma is safe to recieve

A

any - dont have A or B antigen

103
Q

vit K inhibitor that target fibrin clot

A

warfarin

104
Q

what potentiates warfarin - inc INR - risk of bleed

A

hepatic enzyme inhibitors - alcohol, metronidazole, clarithromycin

105
Q

what antagonises warfarin - dec INR

A

hepatic enzyme inducers - carbamazepine, phenytoin

106
Q

what drug potentiates antithrombin and switches off factor X

A

heparin

107
Q

reversal of heparin

A

protamine sulphate

108
Q

monitor of LMWH

A

anti-Xa assay

109
Q

unfractionated heparin monitor

A

APTT

110
Q

how are DOACs excreted and what can it cause

A

via kidneys
can accumulate in renal failure

111
Q

thrombin inhibitor

A

dabigatran

112
Q

blocks COX preventing platelet aggregation

A

aspirin

113
Q

ADP receptor antagonist

A

clopidogrel (antiplatelet)

114
Q

phosphodiesterase inhibitor

A

dipyridamole

114
Q

phosphodiesterase inhibitor

A

dipyridamole

115
Q

thalassaemia inheritance

A

AR

116
Q

HbAS

A

sickle trait

117
Q

HbSS

A

sickle anaemia

118
Q

Tx sickle crisis

A

hyposplenism - penicillin, vaccines
folic acid
hydroxycarbamide - induce HbF production

119
Q

TTP Tx

A

plasmapheresis
steroids
splenectomy

120
Q

ITP Tx

A

steroids
splenectomy
immunosupression - azathrioprine

121
Q

vWD tx

A

desmopressin

122
Q

isolated inc aPTT

A

haemophilia blood test

123
Q

high HbA2

A

beta thalassaemia trait/major

124
Q

Tx of pernicous anaemia

A

hydroxocobalamin for life

125
Q

IgM haemolysis

A

cold AIHA due to infection EBV

126
Q

IgG haemolysis

A

warm AIHA

127
Q

JAK2 inhibitor for myeofibrosis

A

ruxolitinib

128
Q

only acquired thrombophilia

A

antiphospholipid syndrome

y3 summary (7 decks)

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